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Genotypes and infection sites in an outbreak of multidrug-resistant Pseudomonas aeruginosa

A Tsutsui1, S Suzuki, K Yamane

  • 1Department of Bacteriology 2, National Institute of Infectious Diseases, Tokyo, Japan.

The Journal of Hospital Infection
|June 22, 2011
PubMed

Insights

A multidrug-resistant Pseudomonas aeruginosa outbreak in a Japanese hospital was controlled by targeted interventions. Improved catheter care curbed initial strains, while enhanced respiratory care contained later strains, ending the 3-year event.

Area of Science:

  • Infectious Diseases
  • Clinical Microbiology
  • Hospital Epidemiology

Background:

  • An extended outbreak of multidrug-resistant (MDR) Pseudomonas aeruginosa occurred in a Japanese acute care hospital over three years.
  • The pathogen's detection shifted from urine to respiratory samples during the outbreak.
  • All isolates harbored the blaVIM-2 gene, indicating a specific resistance mechanism.

Purpose of the Study:

  • To investigate the epidemiology and control of a prolonged MDR Pseudomonas aeruginosa outbreak.
  • To identify distinct strain types and their transmission patterns.
  • To evaluate the effectiveness of infection control interventions.

Main Methods:

  • Pulsed-field gel electrophoresis (PFGE) was used to classify 51 MDR P. aeruginosa isolates into three main types (A, B, C).
  • Temporal analysis tracked the emergence and dominance of different PFGE types.
  • Multivariate analysis assessed risk factors for detection by respiratory samples.

Main Results:

  • PFGE identified three major clusters (A, B, C) with 8, 19, and 21 isolates, respectively.
  • The outbreak evolved, with initial strains (Type A) followed by Type B, and later Type C.
  • Type C strains showed a significantly higher likelihood of detection in respiratory samples (OR: 11.87).

Conclusions:

  • Targeted infection control measures were effective in controlling the outbreak.
  • Improved aseptic urethral catheter care controlled early strains (A and B).
  • Enhanced respiratory care procedures were crucial in containing the transmission of later strains (Type C).

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